Yonsei Med J.  2008 Dec;49(6):897-900. 10.3349/ymj.2008.49.6.897.

Yonsei Experience in Robotic Urologic Surgery-Application in Various Urological Procedures

Affiliations
  • 1Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. khrha@yuhs.ac
  • 2Department of Urology, Hanyang University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The da Vinci(R) robot system has been used to perform complex reconstructive procedures in a minimally invasive fashion. Robot-assisted laparoscopic radical prostatectomy has recently established as one of the standard cares. Based on experience with the robotic prostatectomy, its use is naturally expanding into other urologic surgeries. We examine our practical pattern and application of da Vinci(R) robot system in urologic field. PATIENTS AND METHODS: Robotic urologic surgery has been performed during a period from July 2005 to August 2008 in a total of 708 cases. Surgery was performed by 7 operators. In our series, radical prostatectomy was performed in 623 cases, partial nephrectomy in 43 cases, radical cystectomy in 11 cases, nephroureterectomy in 18 cases and other surgeries in 15 cases. RESULTS: In the first year, robotic urologic surgery was performed in 43 cases. However, in the second year, it was performed in 164 cases, and it was performed in 407 cases in the third year. In the first year, only prostatectomy was performed. In the second year, partial nephrectomy (2 cases), nephroureterectomy (3 cases) and cystectomy (1 case) were performed. In the third year, other urologic surgeries than prostatectomy were performed in 64 cases. The first robotic surgery was performed with long operative time. For instance, the operative time of prostatectomy, partial nephrectomy, cystectomy and nephroureterectomy was 418, 222, 340 and 320 minutes, respectively. Overall, the mean operative time of prostatectomy, partial nephrectomy, cystectomy and nephrourectectomy was 179, 173, 309, and 206 minutes, respectively. CONCLUSION: Based on our experience at a single-institution, robot system can be used both safely and efficiently in many areas of urologic surgeries including prostatectomy. Once this system is familiar to surgeons, it will be used in a wide range of urologic surgery.

Keyword

Robotics; prostatectomy; urology

MeSH Terms

Aged
Cystectomy/instrumentation/methods
Female
Humans
Korea
Male
Middle Aged
Nephrectomy/instrumentation/methods
Prostatectomy/instrumentation/methods
Prostatic Neoplasms/surgery
Robotics/instrumentation/*methods
Urologic Surgical Procedures/instrumentation/*methods

Figure

  • Fig. 1 The da Vinci® surgical system.

  • Fig. 2 Port placement for robot-assisted laparoscopic radical prostatectomy (A) and cystectomy (B).


Reference

1. Sung GT, Gill IS, Hsu TH. Robotic-assisted laparoscopic pyeloplasty: a pilot study. Urology. 1999. 53:1099–1103.
Article
2. Abbou CC, Hoznek A, Salomon L, Olsson LE, Lobontiu A, Saint F, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol. 2001. 165:1964–1966.
3. Guillonneau B, Jayet C, Tewari A, Vallancien G. Robot assisted laparoscopic nephrectomy. J Urol. 2001. 166:200–201.
Article
4. Lee YS, Han WK, Oh YT, Choi YD, Yang SC, Rha KH. Robot-assisted laparoscopic radical prostatectomy: four cases. Yonsei Med J. 2007. 48:341–346.
Article
5. Park SY, Cho KS, Ham WS, Lee JH, Choi HM, Rha KH. Robot-assisted laparoscopic nephroureterectomy with a bladder cuff excision. Korean J Urol. 2008. 49:373–375.
Article
6. Park SY, Kim HJ, Seo JW, Cho KS, Ham WS, Rha KH. Robot-assisted laparoscopic partial nephrectomy. Korean J Urol. 2008. 49:387–391.
7. Guillonneau B, Rozet F, Barret E, Cathelineau X, Vallancien G. Laparoscopic radical prostatectomy: assessment after 240 procedures. Urol Clin North Am. 2001. 28:189–202.
8. Kavoussi LR, Moore RG, Partin AW, Bender JS, Zenilman ME, Satava RM. Telerobotic assisted laparoscopic surgery: initial laboratory and clinical experience. Urology. 1994. 44:15–19.
Article
9. Cadière GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, et al. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg. 2001. 25:1467–1477.
10. Talamini MA, Chapman S, Horgan S, Melvin WS. The American Robotic Group. A prospective analysis of 211 robotic-assisted surgical procedures. Surg Endosc. 2003. 17:1521–1524.
Article
11. Chang L, Satava RM, Pellegrini CA, Sinanan MN. Robotic surgery: identifying the learning curve through objective measurement of skill. Surg Endosc. 2003. 17:1744–1748.
12. Ahlering TE, Skarecky D, Lee D, Clayman RV. Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol. 2003. 170:1738–1741.
Article
13. Burgess SV, Atug F, Castle EP, Davis R, Thomas R. Cost analysis of radical retropubic, perineal, and robotic prostatectomy. J Endourol. 2006. 20:827–830.
Article
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